Page 24 - Tessenderlo Kerley, Inc 2022 Benefit Guide

IMPORTANT LEGAL RIGHTS INFORMATION

Your current coverage pays for other health care expenses in addition to For More Information About Your Options Under Medicare
prescription drugs. If you enroll in a Medicare prescription drug benefit, Prescription Drug Coverage…
you and your eligible dependents will still be eligible to receive all of your More detailed information about Medicare plans that offer prescription
current health and prescription drug benefits." drug coverage is in the “Medicare & You” handbook. You’ll get a copy
of the handbook in the mail every year from Medicare. You may also be
If you do decide to join a Medicare drug plan and drop your current contacted directly by Medicare drug plans.
Tessenderlo Kerley, Inc. coverage, be aware that you and your
dependents will be able to get this coverage back. For more information about Medicare prescription drug coverage:
Visit www.medicare.gov
When Will You Pay A Higher Premium (Penalty) To Join A Call your State Health Insurance Assistance Program (see the inside back
Medicare Drug Plan? cover of your copy of the “Medicare & You” handbook for their telephone
You should also know that if you drop or lose your current coverage with number) for personalized help
Tessenderlo Kerley, Inc. Employee Benefit Plan and don’t join a Medicare Call 1-800-MEDICARE (1-800-633-4227). TTY users should
drug plan within 63 continuous days after your current coverage ends, call 1-877-486-2048.
you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you have limited income and resources, extra help paying for Medicare
If you go 63 continuous days or longer without creditable prescription prescription drug coverage is available. For information about this extra
drug coverage, your monthly premium may go up by at least 1% of the help, visit Social Security on the web at www.socialsecurity.gov, or call
Medicare base beneficiary premium per month for every month that them at 1-800-772-1213 (TTY 1-800-325-0778).
you did not have that coverage. For example, if you go nineteen months Remember: Keep this Creditable Coverage notice. If you decide to join
without creditable coverage, your premium may consistently be at least one of the Medicare drug plans, you may be required to provide a copy
19% higher than the Medicare base beneficiary premium. You may have of this notice when you join to show whether or not you have maintained
to pay this higher premium (a penalty) as long as you have Medicare creditable coverage and, therefore, whether or not you are required to
prescription drug coverage. In addition, you may have to wait until the pay a higher premium (a penalty).
following October to join.
Date: 10/15/2021
For More Information About This Notice Or Your Current Name of Entity/Sender: Tessenderlo Kerley, Inc.
Prescription Drug Coverage… Contact--Position/Office: Kathy Pevan
Contact the person listed below for further information. NOTE: You’ll get Address: 2910 N. 44th St., Suite 100, Phoenix, AZ 85018
this notice each year. You will also get it before the next period you can join Phone Number: 602-889-8325
a Medicare drug plan, and if this coverage through Tessenderlo Kerley, Inc.
changes. You also may request a copy of this notice at any time.

WELCOME BENEFIT BASICS MEDICAL DENTAL VISION FSA ADDITIONAL BENEFITS 401(k) CONTACTS LEGAL RIGHTS 24